Aging in Place in Your Rhode Island Community

Published in RINewsToday on May 2, 2022

As the graying of the nation’s population continues, older persons are choosing to live out their remaining years remaining in their communities in their homes, whenever possible. A new just-released study of adults age 50 and older from the AP-NORC Center for Public Research and the SCAN Foundation, finds a majority of older persons would like to age in place and are confident they can access needed services that will allow them to stay at home in their community for as long as possible.  

Gathering Thoughts About Aging in Place

According to this new national study released last week, two-thirds of the respondents think their communities meet their needs for accessing services like health care, grocery stores and social opportunities. The researchers found that all types of health care services are widely perceived as easy to access in their communities, and most feel that local health care understand their needs (79%) and take their concerns seriously (79%).

But, a closer examination of the small proportion of older Americans (Blacks and Hispanics) who feel less prepared and less supported in their community raises concerns about equity in access to the resources necessary to age in place.

However, the study reported that a few respondents say they had a hard time accessing needed services because of communication obstacles like a language barrier (11%), cultural barrier (8%) or age gap (8%); issues with affordability (15%); or issues of respect for their religious (4%) or cultural (3%) background. 

Those in urban areas—and suburban areas especially—describe their communities as having more supports for aging in place than those in rural areas. Older adults in suburban areas see their communities as doing the best job with meeting needs for healthy food, internet access, and the kinds of foods they want to eat. Suburban areas are also seen as better than rural areas in particular at meeting needs for health care and social activities. Older rural Americans are less likely than those living elsewhere to use a range of services simply because they aren’t available in their area. They are less likely to feel that community services are easy to get and designed for people their age than those in urban or suburban communities as well. And they are less likely to think a variety of health care services would be easy for them to access.

Income disparities are also associated with access to critical aging services. Those with incomes of $50,000 and below are less likely than those earning more to have access to services that are in their language (73% vs. 82%), close by or easy to get to (58% vs. 65%), respectful of their religious beliefs (57% vs. 65%), or designed for people their age (53% vs. 63%). When it comes to medical services, they are also less likely to have easy access to dental care, physical therapy, pharmacies, nursing homes, and urgent care than those earning more.

Additionally, those age 65 and older generally feel more prepared and report better access to important community services than those ages 50-64.

Aging in Place in the Ocean State 

For older adults aging in place, in their own homes, is by far the preferred model, says Mary Lou Moran, Director, Pawtucket Division of Senior Services at the Leon Mathieu Senior Center. “In fact, the theme of this year’s federal observance of Older Americans Month “Age My Way” focuses specifically on this very topic. The coordination, accessibility, and connection to services and programs is critical to the successful delivery of services and is where much work needs to be done,” she says. 

Moran says that senior centers located in communities throughout the state deliver needed information and assistance to older adults on accessing the needed  services to age in place.  Social isolation, access to transportation, food and housing insecurity, economic stability, and connectivity to services, are obstacles to enabling a person to stay in the community in their homes, adds Moran.

Over the years, Rhode Island’s inadequate Medicaid rates have become major obstacles to allowing a person to stay at home. However, recent state legislation, H 7616, to recreate a Department of Healthy Aging, spearheaded by Reps Carson, Ruggiero, McLaughlin, Contvriend, Speakman, Ajello and Potter, addresses some of the challenges that service providers are facing when trying to assist individuals to age in place. Moran adds, as the number of older adults continues to grow exponentially, the time has come to fully put the needs of our elders in the fore front to enable them to age with choice, dignity and respect.

According to Maureen Maigret, policy consultant and Chair of the Aging in Community Subcommittee of the Long-Term Care Coordinating Council, “Rhode Island is fortunate to have a number of government-funded programs that help older adults to age in place.” These programs include Meals on Wheels home-delivered meals program; Medicaid home and community services including home care, adult day services; assisted living and self-directed programs; Caregiver respite and support services; Home Modification grants to help make homes accessible; and elder transportation assistance for those age 60+ for medical trips, to get to adult day.  She also mentioned the Office of Healthy Aging’s Home Cost Share program for persons age 65+ and persons underage 65 with dementia who are not Medicaid eligible with income up to 250% of the federal poverty level and the wonderful programs offered at the state’s senior centers.

However, Maigret says that for some of these services such as home care there may be wait lists due to worker shortages. (People can find out about these programs or to find out what benefits they may be entitled to by calling the POINT at 401-462-4444).

There are also private services available for almost any service needed to help people age in place if they have the financial means to pay for them,” says Maigret.  

The National Village to Village Movement Comes to Rhode Island

While some of these volunteer programs in RI may offer some type of services such as transportation, a relatively new initiative has come to Rhode Island. “The Village Common of Rhode Island (TVC) provides a variety of supports through the efforts of almost 200 trained and vetted volunteers,” says Maigret. 

Maigret says that the goal of TVC is to help older persons to stay in their own homes and connected and engaged with their community. “This “neighbor helping neighbor” model started 20 years ago in Beacon Hill Boston and now there are 300 nonprofit “villages” operating across the country. TVC supports include transportation, running errands, home visits and telephone assurance, minor home repairs and light yard work, assistance with technology, and a virtual caregiver support program. A robust weekly calendar offers virtual events, and a monthly newsletter keeps members and guests informed. All this is done with a lean 1.5 person staff, a working board of directors and almost 200 volunteers,” she notes. 

“I had heard about the “village” model some years back and supported efforts to start a “village” in Rhode Island, she says. “It amazes me that a small band of committed volunteers were able to put all the pieces in place to operationalize a “village” and to see what has been accomplished. There are now active “villages” in Providence, Barrington, Edgewood/Cranston and Westerly with almost 300 members and more “villages” are under development. One of the priority goals of the Board is to reach out to underserved neighborhoods in our urban and rural areas to listen to people and find out what is important to them and what type of “village” program might work in their area,” she says. 

“We know that transportation is a huge issue for folks living in our rural areas and that is a huge concern. And, based on findings of the 2021 RI Life Index: Older Adults in Rhode Island(from RI Blue Cross Blue Shield//Brown University School of Public Health), we know that older persons of color living in our core cities have lower perceptions of community life, access to healthcare and experience lower food security and access to technology,” adds Maigret.  

“Research on the fairly new “village” programs shows promise in fostering feelings of being connected to others and suggest older women living alone with some disability most likely to experience improved health, mobility and quality of life (https://pubmed.ncbi.nlm.nih.gov/28509628/.),” says Maigret, noting that this is an important finding as Rhode Island has such a high portion of older adults living alone.

TVC President Anne Connor (74) says she has been a member and volunteer since 2015. “That we are volunteer supported is noteworthy and having an Executive Director, Caroline Gangji, (formerly acting Executive Director at Age Friendly RI), improves our ability to serve our members”, says the retired librarian and paralegal.

As TVC founder Cy O’Neil once said, ” …you don’t create a fire house when the house is burning.”  TVC is more than services – it is the relationships we build that are key to our success, says Connor.  

For details about The Village Common Rhode Island, go to https://www.villagecommonri.org/.

For specifics programs and services offered by the Rhode Island Office of Healthy, go to  https://oha.ri.gov/.  

Senior Centers, Not Just a Place to Play Bingo

Published February 1, 2013, Pawtucket Times

Today’s senior centers are not the places our parents once visited to knit or play bingo. Established in the 1980s by the U.S. Administration on Aging, the centers programming has slowly evolved to encompass activities that encourage healthy aging and wellness, says Mary Lou Moran, who oversees Pawtucket’s Leon A. Mathieu Senior Center. Established in 1980, last year over 15,000 clients took advantage of programs and social services offered, or to eat a nutritious meal, she notes.

At Rhode Island’s 47 Senior Centers, “We are now looking at the whole person, the body, mind and spirit,” notes Moran, a former Program Coordinator who now serves as Director of Senior Services. “It is very important that we encourage individuals to live independently and safely in their communities.”

At the Leon Mathieu Senior Center, health screenings, specifically taking blood pressure readings, are performed by nursing students from Rhode Island College and URI Pharmacy students, notes Moran. “Proper nutritional counseling is a very big deal, too,” she adds, noting that a nutritionist is available to provide individual counseling.

Through the Eyes of Clients

Linda Slade discovered the Leon Mathieu Senior Center after retiring from working in retail for over 38 years. Initially, attending a few exercise activities in October 2010, she was forced to stop attending, taking care of her terminally ill husband. After his passing she came back four months later “to just be with people again.”

Slade, initially had misconceptions about Pawtucket’s Senior Center. “I was a young sixty-two and not really sure what to expect,” she said, expecting to be surrounded by very old people. That first visit totally changed her mind, seeing younger people. Besides knitting, playing cards or cribbage, the Pawtucket resident participates regularly in arthritis class, stretch exercises and Tai Chi.

Before attending the Senior Center’s exercise classes, Slade’s son had given her a gym membership. “Basically I was intimated to go because of the younger people,” she says. Now Slade is more comfortable working up a sweat with her Senior Center exercise companions.

According to Slade, the City’s Senior Center offers something [activities] for everyone, her involvement even gave her an opportunity to develop new social bonds. “I had a work family that I truly adored, but now I adore my Senior Center family, too” she said. Just like the fictional bar, Cheers, Slade knows everyone’s name in all her activity groups.

“Going bonkers” and feeling a need to get out of her home propelled Nancy Connor, 79, a former Secretary to the CEO of Citizens bank, to the doors of the Leon Mathieu Senior Center. Aortic valve surgery forced the Pawtucket resident into an early retirement in her early seventies from a job she loved and found intellectually challenging.

Once the Pawtucket widow, who lives with her companion, Mave, a 60 pound Royal Standard Poodle, found the Leon Mathieu Senior Center in the Yellow Page Directory, she went to see what it was all about. She’s been going daily ever since.

The Grand Dame of the Literary Circle

Like Slade, before attending, Connor had a misconception about Senior Centers, thinking that she would see “a bunch of old people doddering along.” Now the enthusiastic participant has found out that this was not the case.

According to Connor, not as many men come into the Center. “We really do outnumber them,” she quips, noting that they “usually appear out of thin air when there is a high-low jack game.

Walking with a cane keeps Connor from exercising but she hopes to some day explore the Chinese practice of Tai Chi. However, she gets activity involved in other pursuits. Never published, she took up writing, participating in the Book and Drama Clubs, and now considers herself the “Grandma Moses” of the Senior Center’s literary circle.

Meanwhile, Connor and a few other older participants meet monthly with third year Brown Medical students to teach them the art of speaking to the “geriatric crowd,” she says. At Friday coffee hours, invited guests come into the Senior Center’s large activity room to entertain, teach or educate, she says. If a cancellation happens, she’s drafted to play piano for the crowd in the activity room.

Like in Senior Centers across the Ocean State, every day Connor can eat lunch, only paying a minimal fee. “It is wonderful stuff, from soup to nuts,” she remarks.

A Medical Model

Jill Anderson, Executive Director of Senior Services Inc., a private nonprofit corporation established in 1975, manages the Woonsocket Senior Center. Each day over 100 clients (around 500 annually) participate in exercise activities and health and wellness programs at her site. A day care program in her building handles 35 people who have limitations in their daily living.

Reflecting its medical model philosophy, the Woonsocket Senior Center’s registered nurse, who also serves as the Wellness Director, counsels people on how to change behaviors to maintain better health. Health screening, including blood pressure checks, diabetic and bone density testing are also part of a Wellness program.

About 20 retired volunteers regularly help out each day serving lunch and assisting staff, notes Anderson. “These individuals create a friendly atmosphere for the new clients, making sure they don’t sit by themselves.”

Although many of Rhode Island’s Senior Centers have an annual membership fee or charge registration fees to participate in activities, Anderson’s nonprofit does not. “We just ask people to make a voluntary weekly contribution of one dollar to fill the gap that fundraising, grants and memorials don’t cover.”

Like in many other Senior Centers, computer courses in a computer lab is offered, says Anderson. “We would like to do more with computers, maybe we can some day offer both Intermediate and Advanced computer classes, too,” she adds, because the older clients are interested in embracing new technology, like I-pads, and smart phones.

“A Benefits Councilor also is on site to identify benefits and programs our clients are entitled to receive, states Anderson, this ultimately helping to lower the cost of supplemental Medicare plans, and make other economies.

Pumping Weights

Robert Rock, Director East Providence Senior Center, on Waterman Ave., provides all the typical exercise programs that Senior Centers offer. But through a $96,000 grant received from the U.S. Administration on Aging, his Senior Center now houses the only fitness center in the Ocean State.

“The [fitness] program promotes attitude change and development of appropriate exercise skills and reduces the risks of a sedentary lifestyle. It also improves the quality of life for our senior population,” Rock says.

According to Rock, a client can gain privileges to using the fitness room for a very minimal fee of $40 for single membership, $60 for couples. Equipment includes three treadmills, two recumbent bikes, an elliptical stepper, hand weights and six dual weight machines. Other features include a matted floor, mirrored walls, water, stereo, and cable TV.

Rock notes that 90 percent of the 258 people, mostly in their 60s, are taking advantage of this fitness center room, an attachment to the Senior Center. “They come to work out and then leave,” he says, noting that the oldest, a 91-year old man comes to work out three days a week.

Rock believes that once aging baby boomers come to us for the fitness room, they will choose to come back for other programs and services offered by his Senior Center.

Walking is also an important exercise, too, says Rock. Many clients take advantage of using the Senior Center’s half mile walking track.

Finally, Rock adds that the East Providence Senior Center is also a Rhode Island state-certified site for diabetes education. Both classes and individual counseling are offered.

In conclusion…

Starting in church basements, many as small social clubs, the passage of the Older Americans Act in 1965, propelled Senior Centers into a key provider in the nation’s long term care continuum of care.

Today, 11,000 senior centers serve one million older adults every day. In Rhode Island, 47 agencies, serving 208,000 persons, are geographically spread out from Westerly to Woonsocket and from Foster to Tiverton. Some are managed by municipalities, others by nonprofit groups. While catering to serving the state’s burgeoning elderly population, some have expanded their mission to offer programs for young and middle age adults.

While the average age is age 75, many of Rhode Island’s Senior Centers are adjusting their programming and services to attract the state’s aging baby boomers by focusing on health and wellness, recreation and life long learning.

According to Rhode Island’s Division of Elderly
Affairs (DEA), over 14 percent of Rhode Island’s population is age 65 and over. By 2030, its projected to grow to over 21 percent. Rhode Island’s senior centers are a key provider to keep the aging baby boomers, healthy, independent and at home.

Yes, today’s Senior Centers are not your parent’s bingo hall, as some mistakenly believe. Why not visit your local senior center you may even be surprised with what you find. Call DEA for a complete listing of the state’s senior centers at 401/462-3000.

Herb Weiss, LRI ’12, is a freelance writer covering aging, health care and medical issues. He can be contacted at hweissri@aol.com.

The Best Of…Day Services Help Seniors Stay at Home

Published on May, 7, 2001, Pawtucket Times

            Like apples and oranges, senior centers and adult day care are quite different.  But when viewed as complementary community-based services, each can be instrumental in keeping elderly Rhode Islanders independent and at home.

           While senior centers serve the independent older population, programs and services provided by adult day care centers are specifically designed for functionally or cognitively impaired adults.

          Senior centers can serve as “brokers” between the elderly and the surrounding community, creating access to a wide variety of programs and services, states Rick Ryan, former chair of the Washington, DC-based National Institute for Senior Centers and director of senior services for South Kingstown.

        According to Ryan, some people today still believe the myth that senior centers are drop-in centers or “play pens for the frail aged where persons are spoon-fed programs and services.”  Not true, he says.

        “Indeed we have come a long way,” Ryan noted, stating that “senior centers are not developed through a cookie cutting process.”  Programs across the nation are as varied and diverse as the older population that they serve.  In fact, he says, senior centers evolved in response to their surrounding communities and reflect the interest and values of those older adults who not only participate in their programs, but also help shape them.

        For those participating, Ryan stated hat senior centers offer a menu of activities, with older participants being allowed to develop and design their own programs. Activities can range from computer labs offering Internet access, yoga, line dancing, aerobics, playing cards, art classes or even shooting pool.

         Since the early 1970s, adult day care centers have existed. According to the National Association of Adult Day Services in Washington, DC., here are more than 3,000 adult day care centers currently operating nationally.

         “There are 16 state-certified adult day care centers in Rhode Island,” noted Ryan, who also is a member of the Rhode Island Adult Day Services Association, a group representing programs in all of the state’s 39 cities and towns.

         Ryan stated that adult day centers provide a comprehensive planned program of health, social and support services in a protective setting during daytime hours.  “Activities include mental processing programs such as current affairs and word association games to stimulate thinking more physical activities like volleyball, dancing and range of motion exercises.”

         Services at adult day centers are specifically designed to meet the individual needs of the elderly and strongly focus on ways to help relieve the stress of the caregivers.  Such programs are critical in assisting caregivers to maintain their loved ones at home in the community.

       Adds Sharon Rice, director of the Comprehensive Day Care Center, a program of the Jewish Seniors Agency, “One of the most important factors of a day care program is that adult children taking care of elderly frail parents don’t have to worry about how they can take care of their parents, work a full-time demanding job while caring for their children.”  She noted that most adult children prefer to have their parents “age in place” at home rather than have to institutionalize them in a nursing home.

   According to Rice, today’s day care centers in Rhode Island have undergone vigorous licensing procedures through the state’s Department of Elderly Affairs to ensure quality.

          Ensuring quality through licensure can increase the adult children’s willingness to place his or her parents in an adult day care program, she said.

         Currently, Rice states there are 30 frail elderly persons enrolled in her day care program, attending each day.  Although located in Wayland Square on Providence’s East Side, Jewish Seniors Agency program, established in 1974, also serves East Providence and nearby Pawtucket.

         Keeping a person at home is not always the best option. Rice says, because the older person becomes isolated. “Day care can promote friendship, social interaction and therapeutic activities,” she added.

        “Person with Alzheimer or related-dementia, Parkinson’s disease or  who have suffered strokes receive supportive services at the day care center from a registered nurse, a professional social worker, and a certified nursing assistant,” Rice added, noting that participants also are served kosher meals.

      When adult children are faced with care giving responsibilities for their loved ones they do have a choice – to keep the person at home and not in a nursing home, Rice quipped.  “Adult children should feel comfortable in knowing that they can keep a frail elderly family member at home and in the surrounding community.

         Herb Weiss is a freelance Pawtucket-based writer who covers aging, health care and medical issues.   He can be reached at hweissri@aol.com.